Biatrial function before and after percutaneous closure of atrial septum in patients with and without paroxysmal atrial fibrillation. a two-dimensional and three-dimensional speckle tracking echocardiographic study

We aimed to analyze atrial function by two-dimensional (2DSTE) and three-dimensional (3DSTE) speckle-tracking echocardiography in patients with atrial septal devices and paroxysmal atrial fibrillation (PAF). One hundred sixteen patients and a subgroup of 22 patients who developed PAF after device insertion were studied. Left (LA) and right atrial (RA) peak longitudinal strain (PS) and standard deviations(SDs) of times to peak strain (TPS) were calculated using 2DSTE. LA-RA emptying fraction (EF) and expansion index (EI) were determined using 3DSTE. By multivariate analysis, pre-closure 3D-RA-EI, LA-TPS, and 3D-LA-EI were independently associated with PAF. ROC analysis showed better diagnostic accuracy of the combination of pre-closure TPS and 3D-EI for detecting PAF than the other indices. Patients with atrial septal devices have pre-existent left and right atrial dilatation and dysfunction as assessed by 2DSTE and 3DSTE that appear sensitive for the stratification of PAF risk in this population.